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Tip: Do some research when treating undocumented immigrants

Compliance Monitor, September 8, 2004

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In line with the Medicare Prescription Drug, Improvement and Modernization Act of 2003, (MMA) Congress appropriated $1 billion in 2003 to help hospitals and others with the emergency services they provide to undocumented and certain other classifications of aliens.

Hospitals seeking a piece of the pie likely will have to follow strict standards when they report unreimbursed care provided to undocumented immigrants.

"Hospitals should always be able to have verifiable documentation when requesting money from the government," says James Kopf, former director of the OIG's criminal investigations division and current president of Healthcare Oversight, Inc.

When treating and billing for the unreimbursable care given to undocumented immigrants, it's important to find out what's been done at other facilities.

Border states, for example, will have a larger percentage of undocumented immigrant patients. If you work at a hospital in a border state, does the percentage of undocumented immigrants fall within regional averages? Are you too high? Too low? What is the norm for nonborder states?

To find benchmarking data, Kopf says to look on the CMS Web site or the U.S. Census Bureau.

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